Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Department of Neurology, Hôpital Fondation Adolphe de Rothschild, Paris, France/Department of Neuro-Ophthalmology, Hôpital Fondation Adolphe de Rothschild, Paris, France.
Mult Scler. 2021 May;27(6):855-863. doi: 10.1177/1352458520937281. Epub 2020 Jul 7.
A paradoxical discrepancy between severe peripapillary retinal nerve fiber layer (pRNFL) atrophy and good visual outcome had been reported in patients with myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG)-associated optic neuritis (ON). However, only visual acuity (VA) was assessed.
To study visual field (VF) outcomes of patients with MOG-IgG-associated ON and evaluate the correlation between functional eye outcome and retinal structural changes assessed by optical coherence tomography.
The records of 32 patients with MOG-IgG-associated ON who underwent ophthalmological examination at least 12 months after ON onset were reviewed. Degree of VF disability was determined by mean deviation (MD).
At final assessment (median, 35 months), 4.2% of 48 affected eyes (AE) had VA ⩽ 0.1, 40% had abnormal MD, and among AE with final VA ⩾ 1.0, 31% had mild to moderate damage. Thinning of the inner retinal layers was significantly correlated with MD impairment. Analysis demonstrated a threshold of pRNFL thickness (50 µm), below which MD was significantly worse (mean, -2.27 dB vs -17.72 dB; = 0.0003). ON relapse was significantly associated with poor visual outcome assessed by MD.
Functional impairment measured with VF is not rare, and MD assessment better reflects actual structural damage.
髓鞘少突胶质细胞糖蛋白免疫球蛋白 G（MOG-IgG）相关性视神经炎（ON）患者存在严重的视盘周围视网膜神经纤维层（pRNFL）萎缩与良好的视觉预后之间的矛盾差异。然而，仅评估了视力（VA）。
研究 MOG-IgG 相关性 ON 患者的视野（VF）结果，并评估功能眼部预后与光学相干断层扫描评估的视网膜结构变化之间的相关性。
回顾了至少在 ON 发病后 12 个月接受眼科检查的 32 例 MOG-IgG 相关性 ON 患者的记录。平均偏差（MD）确定 VF 障碍程度。
在最终评估（中位数 35 个月）时，48 只受影响眼（AE）中有 4.2%的 VA ⩽ 0.1，40%的 MD 异常，在最终 VA ⩾ 1.0 的 AE 中，31%有轻度至中度损害。内视网膜层变薄与 MD 损害显著相关。分析表明，pRNFL 厚度存在阈值（50μm），低于该阈值时 MD 显著更差（平均值-2.27dB 与-17.72dB； ⁇ = 0.0003）。ON 复发与 MD 评估的不良视觉预后显著相关。
VF 测量的功能损害并不少见，MD 评估更好地反映了实际的结构损伤。
